| NPI | 1972168060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA214179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61071571) |
| Enumeration Date | 2019-05-05 |
| Last Update Date | 2023-06-06 |